Waliwo ekiziyiza omusaayi okuyingira n’okufuluma mu mutima gwo? Kino kiyinza okuba (Obstructive Shock)!

Omusaayi bwe gutatambula bulungi mu mubiri gwaffe gwonna, ekitegeeza nti ebitundu byaffe tebifuna mukka gwa oxygen gwetaagibwa, tutera okuguyita ‘shock’. Kino kibaawo mu bwangu. Leero tugenda kwogera ku kika kya ‘shock’ eky’enjawulo, naye nga tekitera kubaawo. Kiyitibwa `(Obstructive Shock)'. Mu ngeri ennyangu, ekibaawo mu mbeera eno kiri nti waliwo ekiziyiza omusaayi okutambula okutuuka ku mutima gwaffe era omusaayi ne gufuluma mu mutima, kwe kugamba, `okuziyiza' ne kubaawo. Olw’okuzibikira kuno, omutima tegusobola kukola bulungi, puleesa esobola okukka amangu, era omubiri guyinza okubulwa omukka gwa oxygen. Eno mbeera ya mangu nnyo , kale kikulu nnyo okufuna obujjanjabi mu bwangu.

Kale kino `(Obstructive Shock)` kye ki? Tukinnyonnyoleko katono?

Teebereza omutima gwaffe gulinga ppampu y’amazzi. Pampu eno y’esindika omusaayi mu mubiri gwonna. Kati, kiki ekibaawo singa amazzi agayingira mu ppampu eno gazibikira mu payipu, oba singa payipu efuluma mu ppampu ezibikira? Amazzi tegakulukuta bulungi, nedda? Ekyo kye kibaawo mu `(Obstructive Shock)`.

Ekintu ekiziyiza okutambula kw’omusaayi okuyita mu misuwa eminene (egiyitibwa `emisuwa eminene`) egigatta omutima. Kino kiremesa omutima okufuna omusaayi ogumala, era tegusobola kugufulumya nga bwe guli. Ekivaamu kwe kuba nti ebitundu ebisinga obukulu mu mubiri gwaffe, obwongo, ensigo, n’amawuggwe, tebifuna mukka gwa oxygen gumala. Eno mbeera ya mangu eyinza okutta omuntu.

Njawulo ki eri wakati wa `(Cardiogenic Shock)` ne `(Obstructive Shock)`?

Bino byombi bya mangu eby’obujjanjabi, naye bibaawo olw’ensonga bbiri.

Okusannyalala kw’omutima kubaawo ng’ebinywa by’omutima byonoonese, gamba ng’okulwala omutima, era omutima ne gulemererwa kutambuza musaayi gumala mu mubiri. Omutima gunafuwa.

Naye mu `(Obstructive Shock),` ebinywa by'omutima bitera okuba ebirungi. Obuzibu tebuli ku mutima, wabula ku kintu ekirala ekitaataaganya emirimu gy’omutima. Lowooza ku bintu bino:

• Bw’oba ​​olina ekizimba ekinene eky’omusaayi mu musuwa omunene (omusuwa gw’amawuggwe) ogugenda mu mawuggwe go.
• Singa omutima gunyigirizibwa ensawo ejjudde amazzi okwetoloola omutima (pericardial tamponade).
• Singa wabaawo obuvune ku mawuggwe era nga puleesa munda mu kifuba yeeyongera nnyo, okugeza, mu mbeera eyitibwa ``Tension pneumothorax''.

Obstructive Shock kwe kuba nti omutima tegusobola kukola bulungi olw’ensonga ey’ebweru nga eno.

Embeera eno eyitibwa ``Obstructive Shock'' ya bulijjo etya? Kikwata kitya ku mubiri?

Obstructive Shock mu butuufu mbeera etali ya bulijjo bw’ogeraageranya n’ebika ebirala eby’okusannyalala. Ebiseera ebisinga kikwata ebitundu 1% oba 2% byokka ku balwadde abakwatibwa ensisi. Amawulire amalungi gali nti kitera okuwona okusinga ebika ebirala eby’okusannyalala, naye singa kijjanjabwa mangu.

Singa tebajjanjabwa mangu, Obstructive Shock emalako ebitundu by’omubiri ebikulu omukka gwa oxygen n’ebiriisa. Kino kiyinza okuvaako ebitundu by’omubiri okwonooneka n’oluusi n’okufa. Eno y’ensonga lwaki kikulu okunoonya obujjanjabi awatali kulwa.

Bubonero ki obwa `(Obstructive Shock)`?

Obubonero bwa kino buyinza okufaananako n'obwo obwa ``Cardiogenic Shock.'' Laba oba bino biwulikika ng'obimanyidde:

• Omutindo gw’okussa gweyongera mu ngeri etaali ya bulijjo.
• Puleesa ekka nnyo (hypotension).
• Omutima gweyongera nnyo (`Tachycardia`). Nga bw’olinga eyaakadduka.
• Enkyukakyuka mu mbeera, oboolyawo ennaku oba okweraliikirira kuyinza okubaawo.
• Omuwendo gw’omusulo ogukolebwa gukendeera nnyo, oba teguliiwo ddala.
• Olususu luwulira nga lunnyogoga era nga lutuuyana.
• Oluusi empewo esobola okukuŋŋaanyizibwa wansi w’olususu (`Subcutaneous emphysema`). Kino kitegeeza nti owulira ng’obuwujjo obutonotono wansi w’olususu.
• Oyinza okulumwa mu kifuba oba mu lubuto.

Bw’oba ​​olina obubonero buno obumu oba obusingawo, kikulu nnyo okugenda mu basawo amagezi amangu ddala.

Biki ebivaako `(Obstructive Shock)`?

Waliwo ebintu ebiwerako ebivaako `(Obstructive Shock)`. Ka tulabe ebikulu bye biruwa:

• `(Tension pneumothorax)` (okugwa kw’amawuggwe): Kino kibaawo ng’empewo eyingidde mu mawuggwe n’etesobola kufuluma, ekigireetera okusibira munda mu mawuggwe. Olwo amawuggwe ne gagwa, ne galeeta puleesa nnyingi munda mu kifuba ne kireetera omutima okutandika okukuba.
• Vena cava compression syndrome: Okunyigirizibwa kw’omusuwa ogusinga obunene mu mubiri gwaffe (the vena cava). Kino kiyinza okutera okubaawo ng’olubuto lunaatera okuggwaako, ng’obuzito bw’omwana bunyigiriza omusuwa guno.
• Obulwadde bw’okunyigirizibwa kw’amawuggwe (amawuggwe): Obulwadde bw’okunyigirizibwa kw’amawuggwe.
• `(High-PEEP ventilation)`: Embeera nga puleesa mu mawuggwe eri waggulu nnyo eri omuntu ayungiddwa ku kyuma ekissa.
• Ebizimba: Ebika by’ebizimba ebimu ebikula munda mu kifuba nabyo bisobola okuziba omutima oba emisuwa eminene.
• Thromboembolism mu musuwa gw’amawuggwe: Kino kya bulabe nnyo. Singa ekizimba ky’omusaayi ekikolebwa mu kifo ng’ekigere kikutuka ne kisibira mu musuwa mu mawuggwe, kiziyiza omusaayi okukulukuta okuva ku mutima okudda mu mawuggwe.
• Pericardial tamponade: Ensawo ennyimpi eyeetoolodde omutima (the pericardium) ejjula amazzi, ne kinyigiriza omutima. Kino kiremesa omutima okukonziba n’okugaziwa obulungi.
• Aortic dissection: Okukutuka mu aorta, omusuwa ogusinga obunene ogufuluma mu mutima.
• Aortic stenosis: Okufunda kw’ekisenge ky’omusuwa mu mutima. Kino kizibuwalira omusaayi okuva mu mutima.
• Hypertrophic cardiomyopathy: Okuziyiza omusaayi okutambula olw’ebinywa by’omutima okugonza ennyo.
• Constrictive pericarditis: Ensawo eyeetoolodde omutima efuuka enzito, ekizibuwalira omutima okukola mu ddembe.

Ekikulu: Bino byonna ebivaako biba bya mangu, n’olwekyo laba omusawo mu bwangu bw’oba ​​olina obubonero.

Otegeera otya `(Obstructive Shock)`?

Omusawo wo ajja kusooka kukukebera. Bajja kuwuliriza omutima gwo n’amawuggwe nga bakozesa ekyuma ekiwuliriza. Obstructive shock mbeera eyinza okweyongera amangu, n’olwekyo kikulu okuzuula amangu.

Okusobola okuzuula obulungi obulwadde buno, osobola okukeberebwa bino wammanga:

• Ultrasound: Kino kiyinza okutunuulira ebintu ng’omutima, emisuwa eminene, n’okumanya oba waliwo amazzi okwetoloola amawuggwe.
• Echocardiogram (Echo): Kino kiringa ultrasound y’omutima. Kisobola okulaba obulungi ennyo enkola y’omutima, embeera ya vvaalu, n’okumanya oba waliwo amazzi okwetoloola omutima.
• Computed tomography (CT) scan: Kino kiyinza okukuba ebifaananyi ebikwata ku kisenge ky’ekifuba mu bujjuvu. Kiyinza okuyamba okuzuula ebintu ng’okuzimba omusaayi, ebizimba, n’okusalako omusuwa gw’omusaayi.
• Electrocardiogram (ECG oba EKG): Kino kikebera amasannyalaze g’omutima. Kiyinza okuyamba okuzuula oba waliwo ekikyamu ku mutima gwo.

Obstructive Shock ejjanjabwa etya?

Okusooka, ojja kuweebwa amazzi aga IV (nga saline - IV crystalloid fluids) era puleesa yo ne oxygen levels zijja kukeberebwa buli kiseera. Olwo, ekisinga obukulu kwe kuzuula ekivaako Obstructive Shock n’ojjanjaba ekivaako ekyo.

Enkola z’obujjanjabi zaawukana okusinziira ku kivaako. Ka tulabe ebyokulabirako ebitonotono:

• Singa wabaawo ekizimba omusaayi (embolism), kiggyibwamu oba nga balongoosebwa oba nga bateekamu kanula (catheter).
• Singa eba ya aortic valve efunda ennyo, ejja kukyusibwa.
• Mu mbeera z’ebinywa by’omutima ebigonvu (hypertrophic cardiomyopathy), obuwanvu busobola okukendeezebwa oba okuyita mu kulongoosa oba enkola ey’enjawulo nga tukozesa omwenge (catheter-based alcohol ablation).
• Bakuwa eddagala erisaanuusa ebizimba omusaayi.
• Singa wabaawo amazzi okwetoloola omutima (pericardial tamponade) oba tension pneumothorax, amazzi oba empewo ejja kuggyibwamu (oboolyawo nga tukozesa akatubu akatono).
• Bw’oba ​​oli ku kyuma ekissa, osobola okukyusa ensengeka yaakyo.
• Mu mbeera nga ``Vena cava compression syndrome'', embeera y'omubiri ekyusibwa.
• Singa puleesa mu mawuggwe eba waggulu, puleesa ekendeezebwa n’empiso oba ttanka.

Eddagala ki erikozesebwa?

Nga ekivaako kijjanjabibwa, oyinza okuweebwa eddagala nga lino okutebenkeza embeera yo:

• Amazzi nga `IV` saline (`IV crystalloid fluids`).
• Eddagala eriweweeza ku puleesa: `(Norepinephrine (Levophed®))`, `(Vasopressin (Vasostrict®))`, `(Phenylephrine (Vazculep® oba Biorphen®))`.
• Bw’oba ​​n’omusaayi omutono, ojja kuweebwa omusaayi oba ebiva mu musaayi (nga obutoffaali obumyufu ne plasma).

Ngenda kuwona mangu ntya oluvannyuma lw’okujjanjabibwa?

Many of the causes of Obstructive Shock need to be treated quickly , nga wano emikisa gy’okuwangaala gye gisinga obunene. Ekirungi nti obujjanjabi buno bukola mangu. Wabula ne bw’omala okujjanjaba ekivaako, kitwala ekiseera omubiri okudda engulu okuva ku bikolwa bya Obstructive Shock. Tosobola kumala gadduka n’okola omulimu gwo.

Entunula ki eri `(Obstructive Shock)`?

Singa tezijjanjabwa, ``Obstructive Shock`` mbeera eyinza okutta abantu bangi. Okuwona kwo oluvannyuma lw’okujjanjabibwa kisinziira ku bintu ebiwerako omuli:

• Kiki ekivaako `(Obstructive Shock)`?
• Kyatwala bbanga ki okufuna obujjanjabi?
• Endwadde ki endala z’olina?
• Obujjanjabi bwakutuukako buwanguzi butya?

Naye nga bwe kyayogeddwako emabegako, emikisa gy'okuwona okuva mu ``Obstructive Shock`` giri waggulu okusinga okuva mu bika bya ``Shock`` ebya bulijjo nga ``Septic Shock``. N’olwekyo, waliwo essuubi.

Nze nneerabirira ntya?

Omusawo bw’amala okukusiibula mu ddwaaliro, olina okugoberera ddala ebiragiro byabwe.

• Ojja kwetaaga okuwummulako awaka okumala akaseera nga tonnadda ku mulimu.
• Olina okumira eddagala omusawo lye yakulagidde mu budde bwennyini . Tolekera awo kumira ddagala lyonna nga bw’oyagala.
• Genda ku ssaawa z‟okugoberera buli kiseera .

Ddi lwe nnina okuddamu okulaba omusawo? Nkole ki mu mbeera ey’amangu?

Kati omanyi ekyakuleetera `(Obstructive Shock)`. Weegendereze singa obubonero obukwatagana n’ekizibu ekyo buddamu okulabika. Bw’oddamu okufuna obubonero obw’engeri eyo, oba omuntu mu maka go bw’alaba enkyukakyuka eno mu ggwe, kuba ku ssimu mangu ekitongole kya 1990 (Wind) Ambulance Service, oba genda mu kisenge ky’abalwadde ab’amangu mu ddwaaliro erikuli okumpi. Ebiseera bye bikulu.

Bibuuzo ki bye nnina okubuuza omusawo wange?

Osobola okubuuza ebibuuzo nga bino:

• Nneetaaga okumala bbanga ki okumira eddagala lye wampa?
• Emikisa ki egy’okuddamu okufuna embeera eno?
• Kino kinaakwata ku mutindo gw’obulamu bwange okumala ebbanga eddene?
• Nkyukakyuka ki ze nnina okukola mu mmere yange ne mu dduyiro?

N’ekisembayo, by’olina okujjukira (Obubaka bw’okutwala awaka) .

Obstructive Shock mbeera etali ya bulijjo naye nga ya maanyi nnyo nga yeetaaga obujjanjabi obw’amangu. N’olwekyo kikulu okumanya obubonero n’okunoonya obujjanjabi mu bwangu. Abasawo bwe banaamala okuzuula ekivaako Obstructive Shock, bajja kutandika obujjanjabi obutuufu.

Jjukira nti abantu abasinga basobola okuwona obulwadde bwa Obstructive Shock, naye kitwala obudde. Gumiikiriza, goberera ebiragiro by’omusawo, era weefaako. Si ggwe wekka, era waliwo abasawo, ba nurse, n’abaagalwa bo abasobola okukuyamba.

` Obstructive Shock, shock, obulwadde bw’omutima, puleesa, oxygen, okuziyiza, obujjanjabi obw’amangu, amawuggwe, omutima